Risk Factors, Prevalence, and Outcomes of Invasive Fungal Disease Post Hematopoietic Cell Transplantation and Cellular Therapies: A Retrospective Monocenter Real-Life Analysis
(1) Background: Autologous, allogeneic hematopoietic cell transplantation (HCT) and other cellular therapies, including CAR T cell and gene therapy, constitute a cornerstone in the management of various benign and malignant hematological disorders. Invasive fungal infections (IFD) remain a significa...
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MDPI AG
2023-07-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/13/3529 |
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| author | Eleni Gavriilaki Panagiotis Dolgyras Sotiria Dimou-Mpesikli Aikaterini Poulopoulou Paschalis Evangelidis Nikolaos Evangelidis Christos Demosthenous Evangelia Zachrou Panagiotis Siasios Despina Mallouri Anna Vardi Zoi Bousiou Alkistis Panteliadou Ioannis Batsis Marianna Masmanidou Chrysavgi Lalayanni Evangelia Yannaki Damianos Sotiropoulos Achilles Anagnostopoulos Timoleon-Achilleas Vyzantiadis Ioanna Sakellari |
| author_facet | Eleni Gavriilaki Panagiotis Dolgyras Sotiria Dimou-Mpesikli Aikaterini Poulopoulou Paschalis Evangelidis Nikolaos Evangelidis Christos Demosthenous Evangelia Zachrou Panagiotis Siasios Despina Mallouri Anna Vardi Zoi Bousiou Alkistis Panteliadou Ioannis Batsis Marianna Masmanidou Chrysavgi Lalayanni Evangelia Yannaki Damianos Sotiropoulos Achilles Anagnostopoulos Timoleon-Achilleas Vyzantiadis Ioanna Sakellari |
| author_sort | Eleni Gavriilaki |
| collection | DOAJ |
| description | (1) Background: Autologous, allogeneic hematopoietic cell transplantation (HCT) and other cellular therapies, including CAR T cell and gene therapy, constitute a cornerstone in the management of various benign and malignant hematological disorders. Invasive fungal infections (IFD) remain a significant cause of morbidity and mortality in HCT recipients. Therefore, we investigated the prevalence and risk factors of IFD following HCT and other cellular therapies in an era of novel antifungal prophylaxis. (2) Methods: In this study, we retrospectively enrolled adult HCT recipients who were treated at our JACIE-accredited center according to standard operating procedures over the last decade (2013–2022). (3) Results: 950 patients who received cellular therapies were studied. None of the 19 CAR T cell and neither of the two gene therapy recipients developed IFD whereas 3/456 autologous HCT recipients who suffered from primary refractory/relapsed lymphomas presented with probable IFD. Overall, 11 patients who received allogeneic HCT experienced probable IFD, possible IFD was found in 31/473, and IFD was proven in 10/473. A second IFD episode was present in three patients. Four-year OS was significantly lower in proven compared to probable IFD (<i>p</i> = 0.041) and was independently associated with HCT-CI (<i>p</i> = 0.040) and chronic GVHD (<i>p</i> = 0.045). (4) Conclusions: In this real-world cohort, the prevalence of proven and probable IFD in an era of novel antifungal prophylaxis was found to be relatively low. However, IFDs were associated with poor outcomes for patients who received allogeneic HCT. |
| first_indexed | 2024-03-11T01:44:52Z |
| format | Article |
| id | doaj.art-233ae688bd1a4859b4bfe53e640a46c6 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T01:44:52Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-233ae688bd1a4859b4bfe53e640a46c62023-11-18T16:18:18ZengMDPI AGCancers2072-66942023-07-011513352910.3390/cancers15133529Risk Factors, Prevalence, and Outcomes of Invasive Fungal Disease Post Hematopoietic Cell Transplantation and Cellular Therapies: A Retrospective Monocenter Real-Life AnalysisEleni Gavriilaki0Panagiotis Dolgyras1Sotiria Dimou-Mpesikli2Aikaterini Poulopoulou3Paschalis Evangelidis4Nikolaos Evangelidis5Christos Demosthenous6Evangelia Zachrou7Panagiotis Siasios8Despina Mallouri9Anna Vardi10Zoi Bousiou11Alkistis Panteliadou12Ioannis Batsis13Marianna Masmanidou14Chrysavgi Lalayanni15Evangelia Yannaki16Damianos Sotiropoulos17Achilles Anagnostopoulos18Timoleon-Achilleas Vyzantiadis19Ioanna Sakellari20Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, GreeceBone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, GreeceBone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, GreeceDepartment of Microbiology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, GreeceSecond Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, GreeceSecond Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, GreeceBone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, GreeceDepartment of Microbiology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, GreeceDepartment of Microbiology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, GreeceBone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, GreeceBone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, GreeceBone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, GreeceBone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, GreeceBone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, GreeceBone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, GreeceBone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, GreeceBone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, GreeceBone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, GreeceBone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, GreeceDepartment of Microbiology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, GreeceBone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece(1) Background: Autologous, allogeneic hematopoietic cell transplantation (HCT) and other cellular therapies, including CAR T cell and gene therapy, constitute a cornerstone in the management of various benign and malignant hematological disorders. Invasive fungal infections (IFD) remain a significant cause of morbidity and mortality in HCT recipients. Therefore, we investigated the prevalence and risk factors of IFD following HCT and other cellular therapies in an era of novel antifungal prophylaxis. (2) Methods: In this study, we retrospectively enrolled adult HCT recipients who were treated at our JACIE-accredited center according to standard operating procedures over the last decade (2013–2022). (3) Results: 950 patients who received cellular therapies were studied. None of the 19 CAR T cell and neither of the two gene therapy recipients developed IFD whereas 3/456 autologous HCT recipients who suffered from primary refractory/relapsed lymphomas presented with probable IFD. Overall, 11 patients who received allogeneic HCT experienced probable IFD, possible IFD was found in 31/473, and IFD was proven in 10/473. A second IFD episode was present in three patients. Four-year OS was significantly lower in proven compared to probable IFD (<i>p</i> = 0.041) and was independently associated with HCT-CI (<i>p</i> = 0.040) and chronic GVHD (<i>p</i> = 0.045). (4) Conclusions: In this real-world cohort, the prevalence of proven and probable IFD in an era of novel antifungal prophylaxis was found to be relatively low. However, IFDs were associated with poor outcomes for patients who received allogeneic HCT.https://www.mdpi.com/2072-6694/15/13/3529antifungalCAR T cell therapyhematopoietic cell transplantation (HCT)immunosuppressioninvasive fungal infectionmold |
| spellingShingle | Eleni Gavriilaki Panagiotis Dolgyras Sotiria Dimou-Mpesikli Aikaterini Poulopoulou Paschalis Evangelidis Nikolaos Evangelidis Christos Demosthenous Evangelia Zachrou Panagiotis Siasios Despina Mallouri Anna Vardi Zoi Bousiou Alkistis Panteliadou Ioannis Batsis Marianna Masmanidou Chrysavgi Lalayanni Evangelia Yannaki Damianos Sotiropoulos Achilles Anagnostopoulos Timoleon-Achilleas Vyzantiadis Ioanna Sakellari Risk Factors, Prevalence, and Outcomes of Invasive Fungal Disease Post Hematopoietic Cell Transplantation and Cellular Therapies: A Retrospective Monocenter Real-Life Analysis Cancers antifungal CAR T cell therapy hematopoietic cell transplantation (HCT) immunosuppression invasive fungal infection mold |
| title | Risk Factors, Prevalence, and Outcomes of Invasive Fungal Disease Post Hematopoietic Cell Transplantation and Cellular Therapies: A Retrospective Monocenter Real-Life Analysis |
| title_full | Risk Factors, Prevalence, and Outcomes of Invasive Fungal Disease Post Hematopoietic Cell Transplantation and Cellular Therapies: A Retrospective Monocenter Real-Life Analysis |
| title_fullStr | Risk Factors, Prevalence, and Outcomes of Invasive Fungal Disease Post Hematopoietic Cell Transplantation and Cellular Therapies: A Retrospective Monocenter Real-Life Analysis |
| title_full_unstemmed | Risk Factors, Prevalence, and Outcomes of Invasive Fungal Disease Post Hematopoietic Cell Transplantation and Cellular Therapies: A Retrospective Monocenter Real-Life Analysis |
| title_short | Risk Factors, Prevalence, and Outcomes of Invasive Fungal Disease Post Hematopoietic Cell Transplantation and Cellular Therapies: A Retrospective Monocenter Real-Life Analysis |
| title_sort | risk factors prevalence and outcomes of invasive fungal disease post hematopoietic cell transplantation and cellular therapies a retrospective monocenter real life analysis |
| topic | antifungal CAR T cell therapy hematopoietic cell transplantation (HCT) immunosuppression invasive fungal infection mold |
| url | https://www.mdpi.com/2072-6694/15/13/3529 |
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